基于《黄帝内经》痹病传变规律窥探弥漫性结缔组织病多系统损伤的防治思路

Exploring the prevention and treatment of multi-system injury of CTD based on the law of transmission of Bi-syndrome in Huangdi Neijing

弥漫性结缔组织病多归属于中医痹病范畴。在中医整体观认识下,痹病的传变具有由表及里、由肢体至五脏的传变特点,《素问·痹论》言:“诸痹不已,亦益内也”,是痹病总的传变趋势。弥漫性结缔组织病多系统受累特点符合痹病的传变规律。膜原与现代医学结缔组织结构相似,是痹病伏邪所在,亦是传变通路。痹病的预后与传变紧密相关,总的来说五体痹易愈,五脏痹难医,因此痹病防传防变是治疗的重点。文章从《黄帝内经》痹病传变趋势出发,基于伏邪是传变基础、膜原为痹病传变通路,启发弥漫性结缔组织病的防治思路。

Connective tissue diseases belong to the category of Bi-syndrome in traditional Chinese medicine(TCM).Under the holistic view of TCM, Bi-syndrome is characterized by the transmission from the surface to the interior;and from the limbs to the five organs. Suwen·Bilun ‘Bi-syndrome will develop inwards before it is cured’, states the general trend of transmission of arthralgia. The multi-system involvement of connective tissue disease is consistent with the transmission law of Bi-syndrome. The membrane-source is similar to the structure of connective tissue in modern medicine, which is where the hidden pathogen lies, and is also the path of transmission. The prognosis of paralysis is closely related to transmission. Generally speaking, the five body arthralgia is easy to heal, and the five viscera arthralgia is difficult to treat. Therefore, prevention of transmission and change of Bi-syndrome is the focus of treatment. In this article, we based on the trend of transmission of Bisyndrome in the Huangdi Neijing to inspire the idea of prevention and treatment of connective tissue diseases. Based on the fact that the hidden pathogen is the basis of transmission and the membrane-source is the transmission pathway of Bi-syndrome, the ideas of prevention and treatment of connective tissue diseases are inspired.